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Questions and Answers
What is the heart rate during the first period of reactivity after birth?
What is the heart rate during the first period of reactivity after birth?
Which physiological change is NOT characteristic of the second period of reactivity?
Which physiological change is NOT characteristic of the second period of reactivity?
What occurs during the period of decreased responsiveness?
What occurs during the period of decreased responsiveness?
What is a common respiratory characteristic observed in the first period of reactivity?
What is a common respiratory characteristic observed in the first period of reactivity?
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How should a healthy newborn be managed immediately after birth?
How should a healthy newborn be managed immediately after birth?
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What is the primary function of lactase in infants?
What is the primary function of lactase in infants?
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What is the primary result of the increase in systemic resistance due to cord clamping at birth?
What is the primary result of the increase in systemic resistance due to cord clamping at birth?
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What kind of stool is typically passed first by a newborn?
What kind of stool is typically passed first by a newborn?
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What does the presence of unconjugated bilirubin indicate in newborns?
What does the presence of unconjugated bilirubin indicate in newborns?
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Which of the following factors stimulates the respiratory center in a newborn?
Which of the following factors stimulates the respiratory center in a newborn?
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At what age does an infant typically start producing IgM?
At what age does an infant typically start producing IgM?
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What respiratory sign indicates distress in a newborn?
What respiratory sign indicates distress in a newborn?
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What factor leads to the closure of the foramen ovale after birth?
What factor leads to the closure of the foramen ovale after birth?
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What is a common characteristic of breastfed infants regarding immunization?
What is a common characteristic of breastfed infants regarding immunization?
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What is the purpose of vernix caseosa in newborns after 35 weeks of gestation?
What is the purpose of vernix caseosa in newborns after 35 weeks of gestation?
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Which of the following is a role of the liver in newborns?
Which of the following is a role of the liver in newborns?
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What is a normal heart rate for a newborn?
What is a normal heart rate for a newborn?
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What common skin change occurs in newborns shortly after birth?
What common skin change occurs in newborns shortly after birth?
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Which statement about murmurs in newborns is correct?
Which statement about murmurs in newborns is correct?
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What helps stabilize glucose levels in newborns after birth?
What helps stabilize glucose levels in newborns after birth?
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What does acrocyanosis indicate in newborns?
What does acrocyanosis indicate in newborns?
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Which substance is crucial for activating coagulation factors in newborns?
Which substance is crucial for activating coagulation factors in newborns?
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What is the average blood volume for a newborn in mL per kg of body weight?
What is the average blood volume for a newborn in mL per kg of body weight?
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What is the significance of desquamation in newborns?
What is the significance of desquamation in newborns?
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Which method of heat loss does NOT apply to newborns?
Which method of heat loss does NOT apply to newborns?
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What might be observed in female newborns due to increased estrogen levels?
What might be observed in female newborns due to increased estrogen levels?
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What is true regarding the closure of ductus venosus?
What is true regarding the closure of ductus venosus?
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What is a common characteristic of the skeletal system in newborns?
What is a common characteristic of the skeletal system in newborns?
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What is the typical outcome for tremors observed in newborns?
What is the typical outcome for tremors observed in newborns?
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What is the consequence of delayed clamping of the umbilical cord?
What is the consequence of delayed clamping of the umbilical cord?
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Which of the following is a normal behavioral adjustment observed in newborns?
Which of the following is a normal behavioral adjustment observed in newborns?
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What is the primary reason for using a syringe on a newborn immediately after delivery?
What is the primary reason for using a syringe on a newborn immediately after delivery?
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What age-related preference do newborns exhibit in terms of vision?
What age-related preference do newborns exhibit in terms of vision?
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Which assessment tool is used to evaluate a newborn's adjustment to extrauterine life?
Which assessment tool is used to evaluate a newborn's adjustment to extrauterine life?
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What is the significance of placing identically numbered bands on the newborn and mother?
What is the significance of placing identically numbered bands on the newborn and mother?
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What is the primary method of heat loss from a newborn's body to the surrounding cooler air?
What is the primary method of heat loss from a newborn's body to the surrounding cooler air?
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What should be monitored if a newborn has not voided within 24 hours?
What should be monitored if a newborn has not voided within 24 hours?
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Which sensory ability is developed well by newborns, allowing them to recognize their mother's presence?
Which sensory ability is developed well by newborns, allowing them to recognize their mother's presence?
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How does brown fat contribute to a newborn's thermoregulation?
How does brown fat contribute to a newborn's thermoregulation?
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What skin color indicator is used to evaluate newborns with darker skin tones?
What skin color indicator is used to evaluate newborns with darker skin tones?
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What is the normal range of urine output for a newborn in the first few days after birth?
What is the normal range of urine output for a newborn in the first few days after birth?
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At what intervals is the Apgar score assigned after birth?
At what intervals is the Apgar score assigned after birth?
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Which of the following statements is true regarding the renal system adjustments at birth?
Which of the following statements is true regarding the renal system adjustments at birth?
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Which intervention is crucial if a newborn is not term, has poor muscle tone, or is not breathing well?
Which intervention is crucial if a newborn is not term, has poor muscle tone, or is not breathing well?
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What physiological change occurs regarding extracellular fluid in newborns after birth?
What physiological change occurs regarding extracellular fluid in newborns after birth?
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What risk is associated with the mucosal barrier in the intestines of newborns?
What risk is associated with the mucosal barrier in the intestines of newborns?
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What characteristic of breast milk contributes to the development of intestinal flora in newborns?
What characteristic of breast milk contributes to the development of intestinal flora in newborns?
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What is the significance of uric acid crystals, also known as 'brick dust', in a newborn's urine during the first week?
What is the significance of uric acid crystals, also known as 'brick dust', in a newborn's urine during the first week?
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What digestive enzyme is notably lacking in a newborn's system, impacting fat digestion?
What digestive enzyme is notably lacking in a newborn's system, impacting fat digestion?
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Study Notes
Newborn Adaptations
- Transition from intrauterine to extrauterine life occurs in 3 stages
- First period of reactivity: lasts up to 30 minutes after birth; HR increases to 160-180, then drops to 100-120, RR is 60-80, irregular respirations, fine crackles, nasal flaring, grunting, chest retractions, alerted, starled, cries, tremors, moves head side to side, bowel sounds audible, meconium passage possible
- Period of decreased responsiveness: lasts 60-100 minutes; infant is pink, RR rapid (60), shallow but unlabored, peristaltic waves, sleeps or has decrease in motor activity
- Second period of reactivity: occurs 2-8 hours after birth; lasts 10 minutes to several hours; brief periods of tachycardia/tachypnea, increased muscle tone, changes in skin color, mucous production, meconium commonly passed; healthy infants experience regardless of gestational age. Very preterm infants may not experience due to immaturity
- Respiratory adjustments:
- Initiation of breathing: increase in systemic resistance due to cord clamping, rise in BP, shunting in lungs to work; crying increases air distribution; mechanical factors (squeeze when passing through birth canal) and chemical factors (activation of chemoreceptors in carotid artery and aorta from hypoxia), sensory factors (suctioning mouth/nose, drying), environmental factors, obligatory nose breathers, signs of respiratory distress (nasal flaring, retractions, grunting, seesaw respirations, RR under 30 or over 60)
- Cardiovascular system adjustments
- Increased pulmonary blood flow from left side increases pressure in left atrium, closure of foramen ovale, mild cyanosis possible in first few days.
- In utero Po2 is 20-30, after birth it is 50. Ductus arteriosus closes by within 24 hours; permanently closes in 2-3 months and becomes a ligament; can reopen w low oxygen.
- Umbilical arteries, umbilical vein, and ductus venosus close and become ligaments in 2-3 months
Newborn Renal System
- Kidneys occupy large portion of posterior abdominal wall.
- Almost all palpable masses in abdomen are renal in origin.
- Small quantity of urine in bladder (40mL); usual void at birth.
- First few days → 15-60 mL/kg/day UO
- After day 4 → voids 6-8 times; pale straw-color indicates hydration
- No voiding after 24 hours = notify newborn health care provider.
- Uric acid crystals “brick dust” normal in first 3-5 days; adequate intake = regain weight in 10-14 days.
Newborn Fluid/Electrolyte Adjustments
- 75% water at birth, reduction in extracellular fluid with diuresis in the first days of life.
Newborn Gastrointestinal System
- GER - can cause dysphagia, esophagitis, and aspiration (GERD).
- Limited ability to digest fats, but can digest protein and carbohydrates.
- Meconium is usually passed within the first 12-24 hours (48 hours in some cases), is typically green/black with occult blood
Newborn Hepatic System
- Liver is important for iron storage, glucose and fatty acid metabolism, bilirubin synthesis, and coagulation
- Newborn removed from maternal glucose → sudden drop in glucose.
Newborn Immune System
- Passive immunity of IgG provides antimicrobial protection for first 3 months.
- Babies produce IgM by 8 weeks and can develop immunity for infections via breast milk.
Newborn Skin
- Skin is erythematous, then fades to normal, and may be mottled or blotchy in extremities.
- Vernix caseosa is a creamy substance that protects the skin and is common in babies. It is typically absorbed after birth and no treatment is necessary.
Newborn Respiratory
- Breast milk aids in the development of healthy respiratory function
- Frequent feedings are vital to maintain a healthy condition.
- Infants may display difficulty breathing and the nurse or physician may place the infant under a warmer to correct.
Congenital and Acquired Neonatal Issues
- Cardiovascular issues (tachycardia, cyanosis, pallor, heart defects/congenital heart block).
- Respiratory (respiratory distress syndrome)
- Gastroenterological (esophageal atresia and tracheoesophageal fistula).
- Neurologic (seizures, cranial differences)
- Hepatic (jaundice).
Nursing Interventions
- Document baseline VS; weight; appearance; meconium passage;
- Assess skin care
- Assess respiratory function
- Assess feeding ability; swallowing
- Monitor for signs for respiratory distress
Newborn Behavior
- Infants spend 16-19 hours/day sleeping & 8-12 hrs waking up
- Infants experience sleep and wake states.
- Infants require consistent feeding and care.
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Description
This quiz covers the key stages of newborn adaptations from intrauterine to extrauterine life. It will explore the periods of reactivity, including heart rate changes, respiratory adjustments, and physiological signs observed in newborns. Test your knowledge on how healthy infants transition after birth.
